Dentists have become more courageous in the implantation of artificial tooth roots in recent years. In the meantime, for example, they are also planting titanium pillars in patients with osteoporosis or diabetes. The risks of implantation in such diseases are now calculable and can be taken into account in the treatment, explains Professor Henning Schliephake. Then the results are no worse than in healthy patients.
Influence of menopause
In women, after the menopause with the estrogen level also decreases mostly the bone density, especially in the spine and the large bones. For example, a 2002 US study shows that in postmenopausal women, the rate of loss of implants was significantly higher at 13.6 percent than at menopausal women (6.3 percent). In postmenopausal women treated with hormones, the loss rate was 8.1 percent.
Osteoporosis: Prepare the implant well
However, the determination of bone density on the arm bone, for example, hardly gives any indication of the bone quality of the jaw, as other studies have shown. Rather, the local conditions at the place of implantation are decisive - and they can only be correctly assessed during the procedure.
"We know, " explains Professor Henning Schliephake from the Department of Maxillofacial Surgery at the University of Göttingen, "under what circumstances we can implant in patients with osteoporosis today." If we do surgery differently, the implant site is treated differently, the worse Taking account of the bone structure and constricting the structurally weak bone, this can significantly improve the prognosis. "
Diabetes: implantation under antibiotics
Diabetes mellitus is no longer a contraindication today. Although the chronic increase in blood glucose levels causes abnormal changes in the blood vessel walls, which leads to a poorer blood supply to the tissues and therefore affects their ability to regenerate. Wound healing disorders can also occur in diabetics.
Cause are disturbances of the unspecific infection defense. In studies with diabetic rats and mice, therefore, the contact between bone and implant is affected accordingly.
No problem with healthy blood sugar levels
But most clinical studies come to other results with only a few exceptions: The loss rates within five years are between four and seven percent in diabetics. Schliephake: "Therapy safety is the same as in healthy patients when perioperative antibiotic treatment is performed." Because even this is shown by studies: without antibiotics and chlorhexidine flushing, the loss rates in diabetics are significantly higher than those of healthy people.
If the diabetics are treated accordingly, the results are just as good as in healthy people. "If the blood sugar level is set well, nothing speaks against an implantation, " concludes Schliephake.